Maciej Zbrzeźniak, Andrzej Borówka, Wojciech Husiatyński, Wojciech Pypno
- Klinika Urologii Centrum Medycznego Kształcenia Podyplomowego w Warszawie
Kierownik kliniki: prof. dr hab. Andrzej Borówka
prostate, benign prostatic hyperplasia, urodynamic study, transurethral electroresection of the prostate
- introduction and aim of the study
- Benign prostatic hyperplasia (BPH) is the most common urinary disorder in elderly men. Surgical treatment results are dissatisfactory in spite of advances in surgical techniques. In such cases, the treatment outcome may be influenced by lower urinary tract disorders other than bladder outlet obstruction (BOO). We conducted a prospective trial using urodynamic study (UDS) to determine poor surgery outcome predictors.
- material and methods
- 105 patients were qualified for surgery according to standard diagnostic procedures. All underwent UDS before and 6 months after surgical BPH treatment. The degree of BOO was determined on the basis of Abrams-Griffith's number (AGno) and bladder contractility based on Bladder Contractility Index (BCI). Surgical treatment efficacy was measured according to the recommendations of the 4th International Consultation on BPH.
- Out of 90 analysed patients, UDS revealed lack of BOO (BOO [-] or BOO [+/-]) in 20 (24.7%) and detrusor hypocontractility (low BCI) in 30 cases (33.3%). Both conditions coexisted in 16 patients (17.8%). In patients with BOO [-] and low BCI, surgical treatment outcome was worse than in patient with BOO and normal BCI: 25% and 57% versus 94% and 90%. The differences reached statistical significance. When both conditions coexisted, the surgical outcome was satisfactory only in 11%.
- UDS enabled the detection of lower urinary tract disorders, which negatively impacted surgical treatment outcome. In patients with BOO [-] and low BCI, dissatisfactory surgery outcome should be expected.
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